The Study Of Risk Factors Of Multidrug-resistant Pulmonary Tuberculosis In Anhui Province

ObjectivesTo analyze the risk factors of multidrug-resistant pulmonary tuberculosis in Anhui Province and provide reference for the government for more efficient prevention and control,so as to carry out targeted,scientific intervention to the high-risk groups of multidrug-resistant pulmonary tuberculosis,effectively prevent and control the multidrug-resistant pulmonary tuberculosis epidemic in Anhui Province,and curb the spread of multidrug-resistant pulmonary tuberculosis.MethodsA case-control method was used in this study.A inclusion and exclusion criteria was adopted.Patients in the Anhui Province major projects"Research on treatment for multidrug-resistant pulmonary tuberculosis program"were selected.83 patients were from Anhui Provincial Chest Hospital inspection department between January 2013 to December 2015,who was drug sensitivity tested and diagnosed as multidrug-resistant pulmonary tuberculosis.In the same period,98 cases of patients diagnosed as non drug-resistant pulmonary tuberculosis in Anhui Provincial Chest Hospital tuberculosis control clinic were selected as the control group.Data of risk factors of multidrug-resistant pulmonary tuberculosis,including medical record data,questionnaire survey and physical examination were retrieved from all the subjects.Date were processed and analyzed with Epidata 3.0 software and SPSS20.0 statistical software.For continuous variables.The results to mean±standard deviation(mean±SD);categorical variables to the number of cases(percentage)(n,%),the risk factors of multidrug-resistant pulmonary tuberculosis in Anhui Province analyzed by single factor and multi factor analysis,univariate analysis using chi square(x~2)test,single factor analysis of the statistical inspection standards take bilateral=0.2,choose a single factor analysis of P?0.2 related factors into the multiple factor non conditional logistic regression analysis,using stepwise regressive method(likelihood ratio)into the standard model 0.05 and exclusion criteria 0.10.Results1 The single factor analysis found that the case group and the control group of two groups of respiratory symptoms in gender,age,nationality,marital status,BMI,after the first treatment delay time,first medical institutions,respiratory symptoms first diagnosed with pulmonary tuberculosis medical machine structure had no significant difference(P>0.05)and in the place of residence,education level,occupation distribution,the nearest township family per capita monthly income,type of medical insurance,hospitals and residence distance distance,whether the patient received tuberculosis knowledge and treatment in publicity and education,the principles of medicine service family received publicity and education,the principles of medication and treatment of tuberculosis knowledge the pulmonary tuberculosis with attention,whether on their own treatment with the family supervision and support,migrant workers,change of residence,drinking,smoking,eating habits and nutritional status,mental stress,anxiety,engaged in physical labor,sleep time,history of BCG vaccination,taking anti tuberculosis drugs whether adverse reactions,past suffering from tuberculosis,previous anti tuberculosis treatment times,first confirm the diagnosis when lesions by X-ray examination,first diagnosed with X-ray empty number,the first anti tuberculosis treatment effect,treatment during the supervision and treatment enhancement period without supervision in the process,tuberculosis contact history had significant differences(P<0.05).2 Multi factor analysis of this study found that rural residence,education for junior middle school and below,occupation distribution for farmers,family income per month,less of their suffering from pulmonary tuberculosis has not paid much attention,overseas workers,smoking,taking anti tuberculosis drug adverse reactions and past history of tuberculosis,previous anti tuberculosis treatment the number and history of a course in temporary withdrawal or temporary interruption of treatment,first diagnosed when the X-ray lesion number,first diagnosed when the X-ray examination hole number,the first anti tuberculosis treatment did not cure were the risk factors of multidrug-resistant pulmonary tuberculosis(OR=3.146?2.489?2.136?1.800?2.190?2.321?3.158?24.167?10.444?20.369?20.594?3.896?3.037?22.634,95%CI=1.595~4.216?1.117~5.727?1.281~3.053?1.094~2.002?1.056~3.684?1.091~3.765?1.211~4.227?8.334~31.286?6.985~12.227?8.015~22.374?9.349~22.811?1.625~6.012?1.514~5.236?11.246~25.482);the patient received publicity and education on the knowledge of tuberculosis and treatment about medications and treatment of family supervise and support,sleep time guarantee at least seven hours were the protective factors of multidrug-resistant pulmonary tuberculosis(OR=0.050?0.055?0.500,95%CI=0.016~0.215?0.020~0.324?0.015~0.865).ConclusionsRisk factors of multidrug-resistant pulmonary tuberculosis in Anhui Province including:rural residence,education for junior middle school and below,occupation distribution for farmers,the family per capita monthly income less and less attention to their suffering from tuberculosis in migrant workers,smoking,taking anti tuberculosis drugs produce adverse reactions and past diseases over the past anti tuberculosis,tuberculosis treatment times,have a course of temporary withdrawal or temporary interruption of treatment,the X-ray lesion number when first diagnosed,the X-ray examination hole number when first diagnosed,the first anti tuberculosis treatment effect is not cured;protective factors for patients received publicity and education,the principles of medication knowledge of tuberculosis and treatment in the treatment of family supervision and support,ensure that at least seven hours of sleep time.